The Status of Aging and Health in America: Part 1

The Status of Aging and Health in America:
Part I – The Good News And Bad News On Aging

Michael Garko, Ph.D.
Host – Let’s Talk Nutrition

Introduction

“The aging of the U.S. population is one of the major public health challenges we face in the 21st century” (Centers for Disease Control and Prevention and The Merck Company Foundation, p. i, 2007). This challenge is reflected in the growth of our aging population and projections about how it will increase in the near future.

Since 1900, while the population in the United States tripled, the number of older adults (i.e., people 65 or older) has increased 11-fold from 3.1 million in 1900 to 35 million in 2000 (see Centers for Disease Control and Prevention and The Merck Company Foundation, 2004). The fast paced growth of the elderly population will continue as baby boomers (i.e., people born between 1946 and 1964) start to reach age 65 beginning next year. By the year 2030, when the total population of baby boomers will reach age 65, it is predicted there will be approximately 71 million American older adults. Stated another way, in 2030 one in five Americans will be age 65 or older.

The aging challenge facing the nation is reflected in another important way. Although they are living longer, people in the United States are not living necessarily in better health during the latter part of their lifespan. Since 1990, the statistics on healthy life expectancy (i.e., the number years living in a healthy state after age 65) has stayed at 12 years (Merck Institute of Aging & Health and The Gerontological Society of America, 2004). To make aging matters even more challenging, experts project that health care spending in the United States will increase by 25% because of the ever rapidly growing elderly population.

This July, 2010, issue of Healthful Hints is the first in a series on The Status of Aging and Health In America. The focus will be on the current revolution in longevity, life expectancy, healthy life expectancy, differences in life expectancy between women and men and reasons why people are living longer in America.

The Longevity Revolution

The United States is currently experiencing an unprecedented longevity revolution. Americans are clearly living longer. One way to determine quantitatively whether people are living longer is to calculate population longevity using the measure of life expectancy. Life expectancy is the expected average number of years to be lived by a group of people born in a particular year (i.e., cohort), assuming the mortality trends for that group/cohort continue over the life span or for the remainder of the cohort’s life.

Life Expectancy in the United States

Remarkably, life expectancy has increased dramatically in the United States. People who were born in the year 1900 could expect on average to live only 47 years. Children born in 2005 can expect to live nearly 78 years (77.9) (Centers for Disease Control and Prevention, 2007). This is the good news.
The bad news is that compared to other countries the United States does not even rank in the top 25 countries with the longest life expectancy. According to the Central Intelligence Agency (CIA) (2010), the United States ranks 49th in life expectancy out of 224 countries. The CIA ranks Monaco number one in life expectancy at 89.78 years and Angola last with a life expectancy of 38.48 years.

It is important to remember that life expectancy is different from the concept of life span. Life span represents the upper limit of human life which could be reached by a person. The oldest authenticated female life span recorded to date was for J. Calment of France. She died at age 122 years and 164 days, while the oldest authenticated male life span recorded to date was for C. Mortensen (a Danish immigrant to the U.S.). He died at age 115 years, 252 days (see Max Planck Institute for Demographic Research 2010).

Healthy Life Expectancy

As it was pointed out above, although the statistic on life expectancy in the United States has steadily improved over the past hundred years, the statistic on healthy life expectancy (i.e., the number years living in a healthy state after age 65) seems to have stalled, remaining at 12 years since 1990 (Merck Institute of Aging & Health and The Gerontological Society of America, 2000). Thus, Americans are living longer but there is concern that they are not necessarily living longer in good health and quality of life.

Differences in Life Expectancy Between Men and Women

The most recent statistics related to the average life expectancy at birth show that for women it is 80.4 years and for men it is 75.2 years (Centers for Disease Control and Prevention, 2007). As they age, the gap in life expectancy for women and men decreases. For example, according to the Centers for Disease Control and Prevention (CDC) (2007), the difference in life expectancy between women and men is 2.9 years at age 65 (20.0 years and 17.1 years, respectively). At age 85 the gap between women and men narrows to just a little more than one year (7.2 years and 6.1 years, respectively). It is interesting to note that since 1979 the gap in average life expectancy at birth between women and men has decreased from 7.8 years to 5.2 years (see Centers for Disease Control and Prevention, 2007).

The CDC (2007) recognizes that average life expectancy at birth for women and men has improved over the last 100 years but suggests that there is considerable room for improvement compared to other countries in their following statistical analysis:

Although life expectancy for both women and men has increased dramatically over the past century, the United States lags behind many other developed countries. For example, in 2002, Japan, Hong Kong, and Spain (ranked 1, 2, and 3) reported life expectancy at birth for women to be 85.2, 84.5, and 83.5 years, respectively, and for men to be 78.3, 78.6, and 75.8 years (ranked 2, 1, and 15), respectively. In 2002, for women the United States ranked 26th in life expectancy at birth and 18th in life expectancy at age 65 years; for men the United States ranked 26th in life expectancy at birth and 13th in life expectancy at age 65 years among 37 selected countries ranked in Health, United States, 2006 (Centers for Disease Control and Prevention, 2007, p. 3).

Reasons Why More People Are Living Longer

One would like to believe that the longevity revolution in the United States was due primarily to a majority of the population living an exemplary healthy lifestyle. However, the remarkable increase in average life expectancy at birth over the past 100 years or more was due to (1) an improvement in sanitation, (2) an increase in use of preventative health services, (3) public health efforts and (4) to some lesser extent healthier lifestyles for a small percentage of the population (see Centers for Disease Control and Prevention and The Merck Company Foundation, 2007; Centers for Disease Control and Prevention and The Merck Company Foundation, 2004).

Conclusion

The portrait of aging in America is a paradoxical one. On the one hand, Americans are living longer than ever before in the history of our country, the proportion of people age 65 and older is increasing and average life expectancy at birth is at an all time high. On the other hand, all of these factors are contributing to an unprecedented increase in our aging/elderly population, for whom healthcare must be provided.

The fundamental challenge facing the country will center on how to provide that healthcare to ever growing elderly population, so as to keep them healthy longer, ensure quality of life and wellbeing and to care for them when they become ill with chronic diseases, all of which begs the question of how will the country pay for the projected commensurate rise in healthcare costs.

Furthermore, while more people are living longer, they are not necessarily living healthier lives, increasing the likelihood of a rise in chronic diseases and healthcare costs. In fact, living a healthier life style is on a decline in the United States, reflected in the reality that two-thirds of the population is overweight or obese and an alarming percentage of the people are living sedentary lives. This topic will be explored in the August issue of Healthful Hints.

In addition to providing and paying for healthcare for the increasing elderly population, while maintaining their quality of life as they move through the life span, there are various political, philosophical, ethical and societal issues which enter into the conversation on the status of aging and health in America. Some of the more important of these issues will be discussed in upcoming issues of Healthful Hints.